| NPI | 1235592197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WR0400X Registered Nurse, Rehabilitation (Licence: NJ 46TA09023600) |
| Additional Taxonomies | 163WR0400X Registered Nurse, Rehabilitation (Licence: DE U2-1125) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2023-06-22 |